The World: Post-Mortem for Charities; Compassion Wasn't Enough in Rwanda

This is a digitized version of an article from The Times’s print archive, before the start of online publication in 1996.
To preserve these articles as they originally appeared, The Times does not alter, edit or update them.

Occasionally the digitization process introduces transcription errors or other problems.
Please send reports of such problems to archive_feedback@nytimes.com.

December 18, 1994, Page 004003Buy Reprints The New York Times Archives

THE epic exodus of Rwandan refugees into Zaire last summer stirred deep compassion among Americans. A restaurant in Boston raised $50,000 by asking diners to pay $1 for a glass of water; at a bar in Fairbanks, Alaska, patrons collected $5,000 one night. Many other Americans simply got out their checkbooks.

"I think it was unprecedented," Julia Taft, president of InterAction, a coalition of more that 150 nonprofit organizations, said of the outpouring of compassion and money. Nearly $100 million in cash and goods was given to charities for Rwanda, she said.

Was the money well spent? No one has suggested that it went into someone's pocket, and it would be too harsh to say it did no good. But in general, United Nations and American officials who coordinated the relief effort say that what the private humanitarian organizations contributed to the well-being of the refugees was not commensurate with the money donated -- that not as many lives were saved as might have been.

No Shortage of Feeling

The people who went to Zaire did not lack compassion and enthusiasm. What they did lack was the experience and skills needed to cope with an emergency in Africa, and too often the charities sent what they thought was needed without consulting the experts on the scene.

It has been an axiom of charitable giving that the best organizations are those with the lowest administrative and overhead costs. But some of the organizations that get the highest praise in Rwanda have the highest overhead. Experienced relief workers say it would have been better if American organizations had spent more on overhead; that might have meant hiring a health specialist, doctor or engineer to help decide how to spend the money.

The Rwandan horror left tens of thousands of children without parents, who were killed when the Hutu massacred the Tutsi or when cholera struck the Hutu refugees who fled to Zaire. The children were often cared for in centers supported by American charities. "The medical care in many centers for unaccompanied children was poor," said Dr. Bradley Woodruff, who works for the Centers for Disease Control and was in the camps in Zaire this summer. In particular, he said, the foreign medical volunteers did not know how to treat children with severe diarrhea. This was because in America, a child with bad diarrhea is taken to a hospital and fed intravenously; in Africa, and especially in an emergency, a hospital and I.V. drug setup are probably not available and someone must constantly give the child fluids.

Cholera was the big killer of the refugees in Zaire, with bodies lined up along the road by the hundreds during two weeks in July. One charity, AmeriCares in New Canaan, Conn., shipped 10,000 cases of Gatorade to Goma, believing that it would provide cholera patients with the fluids they need. "It is the same ingredients you would get in an I.V.," the AmeriCares president, Stephen Johnson, said last summer.

But while Gatorade might be good for athletes, it is not good for cholera, said Dr. Michael Toole, an epidemiologist at the Centers for Disease Control. Gatorade does not have all the essential ingredients that an I.V. has, and people who were given it might have taken more appropriate solutions, Dr. Toole said.

Weakening the impact of the private aid was the refusal of many organizations to coordinate with the experts on the scene. For instance, said Flippo Grandi, who was commander of the relief effort as the head of the office of the United Nations High Commissioner for Refugees, "there was an overkill in the medical sector." The worst of the cholera was over by the time many of the doctors started arriving, and by then what was needed were engineers and sanitation experts, individuals with the skills to set up camps for several hundred thousand refugees, Mr. Grandi said.

A Case for Overhead

The amount consumed by overhead is not always the reliable guide to a charity's effectiveness that it has been thought to be. Oxfam-U.S. has a relatively high overhead -- 11 percent -- but the $1.6 million it raised for Rwanda went to support the work of Oxfam-U.K., which put in a much-needed water system for the refugees. Many organizations, whose overhead was only 1 or 2 percent, received far lower marks from relief organizers.

If officials who supervised the relief effort were to make recommendations on whom to contribute to -- which they won't do for political reasons -- the top of the list would include Oxfam; the International Rescue Committee, which has been assisting refugees since 1933; Doctors Without Borders, the European organization that led the assault on cholera, and Concern, an Irish organization that raises money in the United States. Two lesser-known organizations also draw praise from the experts -- the American Refugee Committee, based in Minneapolis, which sent health teams to Zaire and, even more important, trained local people in health care; and Food for the Hungry, in Scottsdale, Ariz., which ran a camp for orphans.

Often people give money to the organization with the best public relations. Many donors decided whom to give to after consulting a list of organizations working in Rwanda that was drawn up by the Associated Press and published by newspapers across the country.

Some organizations on the newspapers' list were not members of InterAction, the coalition of nonprofit charities, which has adopted ethical standards for its members, including requirements that the board of directors serve without compensation and that its activities be "open and accessible to scrutiny by its donors."

AmeriCares, which was on the list -- and which raised $1.2 million for the Rwandan refugees -- withdrew from InterAction a few years ago because it has a different philosophy and approach to relief.

"We're unorthodox," Mr. Johnson said. "We sort of work by the seat of our pants." AmeriCares' overhead, he said, is less than 1 percent.

InterAction officials said that AmeriCares had withdrawn because it felt that the coalition's ethical code was too strict. Another organization on the newspaper list, but not a member of InterAction, was Operation Blessing, which is affiliated with Pat Robertson's Christian Broadcasting Network. The organization raised $1.7 million for Rwanda, said a spokesman, Jodie Nelson. But figures provided by the organization show that it spent more on flying its volunteers, which included television crews, to Zaire, than on anything else. One reason the air-transportation cost was so high, $356,000, was that the organization rotated its medical missionary teams every two weeks -- sending them home when, experts say, they were just starting to learn what to do.

A version of this article appears in print on December 18, 1994, on Page 4004003 of the National edition with the headline: The World: Post-Mortem for Charities; Compassion Wasn't Enough in Rwanda. Order Reprints|Today's Paper|Subscribe